Less than one percent of adaptation finance targets health, even as climate-sensitive diseases multiply. Africa alone will need roughly $300 billion annually by 2030 to build resilient systems and respond to climate-related loss and damage.
BELÉM, Brazil, Nov 20 2025 (IPS) – Around the world, the climate crisis is fast becoming the biggest public-health threat of the century. Extreme heat now kills more Europeans than any other natural disaster. Floods in Asia displace millions and contaminate water supplies. Mosquito-borne diseases once confined to the tropics are appearing in southern Europe and the United States.
Nowhere, however, are these impacts more visible–or the responses more instructive–than in Africa, which stands at a pivotal moment in the global climate discourse. Home to 17 percent of the world’s people yet responsible for less than four percent of global emissions, the continent is on the frontline of a crisis it did little to cause.
From the Horn of Africa to the Sahel, droughts, floods, and heatwaves are fueling outbreaks of malaria, cholera, and dengue, while undermining already fragile health systems. The climate crisis is no longer a distant environmental threat; it is a daily public health emergency.
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While the Paris Agreement implicitly recognized the importance of health in climate action, it was COP28 in Dubai that marked a watershed moment. For the first time, the world finally began to acknowledge what communities across Africa have long known: climate policy is health policy.
The UAE Declaration on Climate and Health, endorsed by more than 120 countries, acknowledged that every degree of warming worsens public health outcomes and that protecting health systems is essential to climate resilience. Africa’s negotiators were central to that breakthrough–pushing health from the margins to the main stage of climate diplomacy.
Their advocacy has paved the way for the next critical milestone: the Belém Health Action Plan, being launched at COP30 in Brazil. The plan’s pillars–disease surveillance, early-warning systems, climate-smart health infrastructure, and health equity–mirror the priorities laid out in the Common African Position on Climate and Health adopted in Lilongwe and reaffirmed in the Africa Group of Negotiators’ (AGN) Declaration, which came out of the Africa Climate Summit in Addis Ababa.
The AGN was decisive in appointing a climate and health lead coordinator to ensure that health is a key thematic stream within the group, and it is now a key component of their work. The message from Africa is clear: protecting people’s health is the clearest measure of whether climate action succeeds.
Yet the global financing system has not caught up. Less than one percent of adaptation finance targets health, even as climate-sensitive diseases multiply. Despite new pledges at COP28–$300 million from the Global Fund and $100 million from the Rockefeller Foundation–the gap is measured in the hundreds of billions. Africa alone will need roughly $300 billion annually by 2030 to build resilient systems and respond to climate-related loss and damage.
Dr. Richard Muyungi, African Group of Negotiators on Climate Change (AGN) Chair
Philanthropy is waking up–the recently formed Climate and Health Funders Coalition brings together 35 institutional and individual funders and they have just committed an initial $300 million at COP30, but structural challenges remain.
Most existing climate funds remain locked behind complex applications or arrive as loans that deepen debt in economies already under strain. That approach is not solidarity–it is self-defeat. Pandemics, heat-related mortality, and vector-borne diseases do not respect borders. A health emergency anywhere can quickly become a threat everywhere.
COP30 offers the chance to change course. The Belém Health Action Plan must not become another well-intentioned declaration–it needs financing hardwired to outcomes that save lives: clinics able to function through heatwaves and floods, vaccine cold chains powered by clean energy, and community health workers trained to respond to shifting disease patterns.
To make that happen, global donors, multilateral banks, and high-emitting nations should agree on three urgent steps. First, earmark a defined share of climate finance for health adaptation–not as an afterthought but as a performance metric in every climate-finance report; second, shift from loans to grants for health-related climate resilience to prevent compounding debt crises; third, invest in African-led solutions that the rest of the world can adopt or learn from–from Kenya’s heat-health action plans in Nairobi to Tanzania’s clean cooking agenda.
Africa’s experiences offer valuable lessons for the world. The ingenuity that kept health services running through droughts and pandemics is precisely what other countries will need as wildfires, vector migration, and heat emergencies escalate globally. The world should be studying and scaling these innovations–not waiting for crises to reach their own doorsteps.
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Ultimately, if the climate crisis has taught us anything, it is that health security is climate security. What happens in Nairobi or Niamey reverberates in New York and New Delhi. COP30 must deliver ambitious and just outcomes that strengthen adaptation and protect the most vulnerable. We will consider COP30 a failure if it does not deliver an ambitious adaptation decision that resonates with Africa’s climate change impacts and realities.
Leaving Belém with promises alone would be a failure of vision and of justice. Leaving with funded commitments would signal a turning point: proof that the world finally understands that safeguarding health is not a regional concern–it is the foundation of collective resilience and of our shared future.
Desta Lakew is Amref Health Africa Group Director for Partnerships & External Affairs; Dr. Richard Muyungi is African Group of Negotiators on Climate Change (AGN) Chair
IPS UN Bureau